Since his second time period began, President Donald Trump has introduced, negotiated, or floated a flurry of initiatives geared toward taming the excesses of the pharmaceutical trade.
No shock. About 60% of American adults are “worried about being able to afford prescription drug costs for themselves or their families,” a latest KFF nationwide ballot confirmed. More than 80% take into account the value of prescribed drugs “unreasonable,” and most assist elevated regulation to decrease prices. Americans pay about thrice as a lot as individuals in different nations for a similar prescribed drugs.
Last July, Trump despatched letters to 17 drugmakers, demanding they voluntarily decrease drug costs. Then the president mentioned he’d negotiated with more than a dozen pharmaceutical executives one after the other on the White House. In December, he announced that he had compelled them to conform to “most favored nation” pricing on Medicaid, the federal government protection for low-income Americans.
Then got here the unveiling of TrumpRx, a website the place cash-paying sufferers might discover discounted medicines, and a promise to hurry biosimilar merchandise — generic variations of sure high-priced specialty medication — by chopping by means of FDA purple tape.
The scope of those grand gestures stays unsure. But it’s actually lower than what the announcement promised, partly as a result of many particulars of the negotiations, even which medication are lined, are hazy.
White House spokesperson Kush Desai didn’t reply queries about TrumpRx.
Medicaid already buys medication at deep reductions. And different sufferers could nicely have higher choices by means of business drug low cost applications, which provide much more merchandise, or by means of their insurance coverage and related drug firm copayment playing cards.
So, for all Trump’s showmanship, the share of Americans more likely to profit from these choices stays slim, even when some individuals do come out forward.
“If it makes a difference to any patient, it’s a win,” mentioned Mark Cuban, a billionaire investor on his personal mission to deliver down drug costs. He pointed to discounted pricing on TrumpRx for branded fertility medication and GLP-1 weight reduction medication for individuals with out insurance coverage or whose plans don’t embrace protection. Cuban launched the Mark Cuban Cost Plus Drug Co., referred to as Cost Plus Drugs, in 2022 to promote medication cheaply by eliminating middlemen — shopping for from factories and promoting on to customers. Most of the medication he sells are generics.
Aaron Kesselheim, a professor of drugs at Harvard Medical School whose analysis focuses on drug costs, mentioned the Trump bulletins are “one-off agreements made for publicity purposes. They don’t change anything about the way drugs are priced.”
He added: “The agreements are opaque and unenforceable.”
It was unclear, for instance, which medication can be bought at “most favored nation” costs or how precisely that was outlined. But, clearly, not all had been.
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Doing the Math
46brooklyn, a consulting agency and information challenge that tracks brand-name drug costs, discovered that near 1,000 model medication went up in worth in January 2026. What’s extra, 2025 had the best variety of record worth will increase ever. “This is not a material change, it’s business as usual,” mentioned Antonio Ciaccia, the corporate’s co-founder.
In the primary week of 2026, Pfizer raised the record costs of 71 medication by a median of 5% and lowered the value of just one, by 9.8%, the information challenge discovered.
The largest win for sufferers has probably been the Trump administration’s quiet continuation of a Biden administration program: Medicare drug worth negotiation for costly medication. The negotiated reductions on the initial 10 drugs — from blood thinners to insulins to medicines for inflammatory issues — went into impact Jan. 1. With reductions in worth of well over 50% on some merchandise, the estimated $6 billion in annual financial savings allowed this system to cap Medicare sufferers’ out-of-pocket spending on Part D prescribed drugs at $2,000 for 2025 and past.
An further 15 high-priced medication — together with common weight reduction and most cancers medication — had been topic to negotiation in 2025, with discounted Medicare costs taking impact subsequent 12 months. And 15 extra high-priced medication are set for negotiation this year. All advised, the 40 negotiated drug costs are anticipated to avoid wasting Medicare nicely over $20 billion a 12 months.
Even as these reductions take impact, drug trade lobbyists have been working to restrict the affect, with some success. For instance, the One Big Beautiful Bill Act exempts drugs for rare diseases from negotiations.
Still, “this is historic because it’s the first time the United States has negotiated prices, like every other developed country,” Kesselheim mentioned. “And guess what? Innovation didn’t stop.”
Of course, these reductions profit solely Medicare enrollees. The newer Trump administration initiatives assist another sufferers, however they’re restricted and require data of how one can entry the reductions.
Trump’s One-on-Ones
The president’s televised appearances with the heads of main drug corporations resulted in offers, however few, if any, will imply a lot to sufferers. For instance, after Trump met with Albert Bourla, CEO of Pfizer, the corporate introduced reductions on 30-plus medication. Bourla called the deal “a win for American patients, a win for American leadership, and a win for Pfizer.”
The reductions are provided by way of TrumpRx, which, in flip, supply coupons co-branded on GoodRx.com, which already affords low cost coupons for a lot of a whole lot of medicines.
Pfizer made hay of the deal, asserting it was a part of Pfizer’s broader, landmark most favored nation, or MFN, agreement with the U.S. authorities, enabling sufferers to pay decrease costs for his or her prescription medicines “while strengthening America’s role as the global leader in biopharmaceutical innovation.”
Pfizer spokesperson Steven Danehy cited a press launch from September noting that the TrumpRx website affords sufferers financial savings that “range as high as 85%.”
Most of the record options brand-name medication, competing with far cheaper generic variations from different producers, such because the cholesterol-lowering drug Colestid, which TrumpRx lists for “50% off” at $127.91. Generic variations price about $17 on the Cost Plus website.
This means the branded corporations aren’t making a sacrifice by providing them at decrease prices as mirrored on Trump’s portal, mentioned Sean Tu, a patent regulation professional on the University of Alabama. “That’s a sale they would not have made if not for TrumpRx.”
Others are very previous medication, equivalent to Cortef, or hydrocortisone, whose 5-milligram branded Pfizer model is listed at $45 on TrumpRx, half its record worth of $91.80. It sells for a lot much less on Cuban’s Cost Plus website. Still others, such because the $607.20 HIV therapy Viracept, are helpful solely together with different medication that aren’t discounted.
Last week, TrumpRx added Amgen’s Humira, for years the world’s best-selling drug, at $950 a dose, down from a listing worth of almost $7,000. But Humira misplaced its patent safety in 2023, and biosimilars — primarily generic equivalents — have since come to market. More to the purpose, two of these biosimilars are listed on TrumpRx for as little as $207.60 a dose.
Since a lot of the TrumpRx merchandise can be found solely to prospects with out insurance coverage who pay money, the arthritis drug Xeljanz’s drop from $2,277 to $1,518 a month would nonetheless depart it unaffordable.
A Few Notable Deals
The much-touted TrumpRx website, launched Feb. 6, consists largely of Pfizer’s 30 medication (30 of roughly 85) with a smattering of reductions more likely to generate headlines.
These embrace three fertility medication from EMD Serono, a subsidiary of the pharmaceutical large Merck KGaA, the most costly of which, Gonal-F, has a listing worth of $966 however is barely $168 per IVF cycle utilizing a TrumpRx coupon.
They will save ladies hundreds of {dollars} — though the general price of fertility therapy will proceed to place them past the attain of many, since medication signify solely a portion of the fee.
The TrumpRx reductions might cut back the $15,000-to-$25,000 price of a single fertility therapy cycle — ladies usually want two or three cycles to turn out to be pregnant — by about 10%, mentioned Sean Tipton, spokesperson for the American Society for Reproductive Medicine. In some European nations, every cycle prices about $3,000.
In alternate for decreasing these costs, EMD Serono bought tariffs lifted on its largely overseas-produced medicines. It additionally received the appropriate to a sped-up FDA approval course of for a fertility drug it’s been advertising closely in Europe.
Another newsworthy providing on the location resulted from a cope with Novo Nordisk for Wegovy, its GLP-1 drug for weight reduction and diabetes, with the value decreased to as little as $199 a month for the pen. (Many insurers cowl such medication just for diabetes, leaving those that are focused on losing a few pounds paying out-of-pocket. Zepbound, Wegovy’s Lilly & Co. competitor, can be on the record, at $299.)
Pressure has been constructing on Novo and Lilly to decrease the U.S. worth of their GLP-1 medication. The compounds have misplaced patent safety in India, and strain from prospects shopping for abroad will probably improve when generic Wegovy goes on sale in Canada, for as little as $73 a month, probably this 12 months.
In the United States, in the meantime, dozens of patents ought to hold Wegovy generics off the market till 2039, mentioned professor Robin Feldman, a patent professional on the University of California Law-San Francisco. A recent report from the analysis group I-Mak delved into a number of methods patent manipulation retains generics off the U.S. market lengthy after they’re out there in European nations and Canada.
And whereas the Trump administration has vowed to approve biosimilars extra quickly to make sure extra competitors and decrease costs, that will not have a lot affect. The huge hurdle in getting generics and biosimilars to market is usually not FDA approval, however the time it takes to override the thickets of patents that U.S. regulation permits producers to deploy to guard their mental property.
For instance, in 2021, the FDA permitted a generic of Otezla, a well-liked drug for psoriatic arthritis, however it won’t hit the market till 2028. Its entry would require drugmakers to pay rebates to Medicare in the event that they charged this system greater than different developed nations for “single source” medication and biologics. That would primarily permit the Medicare program to piggyback on different nations that negotiate the costs of a number of the most costly medicines. Those applications are nonetheless going by means of the rulemaking course of and, once more, would profit solely these lined by the Medicare program and solely not directly.
The common patient-consumer, if prepared to pay money, could discover some bargains. But getting the very best deal might take numerous mixing and matching, forcing sufferers to turn out to be picky consumers, eyeing offers for important medicines as they might for a carton of milk or eggs.
Data reporter Maia Rosenfeld contributed to this text.
